Cancer specialists in A&E boosts care, saves cash

Installing cancer specialists in hospital A&E departments not only improves diagnosis and treatment of the disease but also reduces hospital stays, according to findings of a UK project across Merseyside and Cheshire.

Around a quarter of cancer patients are diagnosed with their disease through unplanned admissions to hospital - either through A&E or for being in hospital for another reason. Those that come through the A&E route usually have advanced disease, but the absence of cancer experts from the start can cause confusion and avoidable delays to diagnosis and treatment.

This prompted the Clatterbridge Cancer Centre NHS Foundation Trust to establish a stream Acute Oncology teams to provide an emergency cancer service during the week in hospitals with A&E departments in the Merseyside and Cheshire cancer network, to determine whether this could provide a benefit to patients.

Over a 12-month period from April 2012, 787 cancer patients were admitted as an emergency to Southport and Ormskirk hospital trust, either through the A&E Department, or through the Medical Admissions Unit.

Ninety-six percent were seen by the Acute Oncology Team within 24 hours and the rest within 48 hours; previously they would not have been seen at all by oncology consultants.

The findings, presented at National Cancer Research Institute Cancer Conference in Liverpool this week, show that 76% of patients received a "major benefit" by contact with oncology specialists (when previously no such service existed), including faster and more effective advice for medical teams on the most appropriate investigations for new cancer patients, and more effective management of severe chemotherapy or radiotherapy side effects in patients with existing disease.

All-in-all, these benefits cut the average length of stay in hospital to 8.7 days compared within the previous 12.1 days, and the service was also able to care for some patients in A&E or day units, thereby avoiding unnecessary and costly admissions, saving crucial funds and improving the patient pathway.

"This new approach to acute cancer care provides cost savings whilst providing high quality care to cancer patients, making it a win-win for patients and the NHS," noted study author Helen Neville-Webbe, study author, Consultant at The Clatterbridge Cancer Centre and Acute Oncology Consultant at Southport and Ormskirk Hospital.

A&E in crisis?

Meanwhile, the row over the state of A&E departments in the UK and their ability to cope with demand is rumbling on.

Labour leader Ed Miliband lashed out at Prime Minister David Cameron this week for ignoring the growing 'crisis', claiming that A&E targets have been missed for the last 15 weeks before the busy winter season has even arrived.

Cameron has, however, dismissed the claims, arguing that waiting times have fallen to 50 minutes on average (from 70 minutes when Labour was in command) and the number of emergency consultants in A&E has increased from five years ago.

Nevertheless, a senior ward consultant also warned this week that the UK is facing its "worst winter yet" because of growing pressures from soaring demand, doctor shortages and "toxic" overcrowding on wards.

Speaking to BBC Radio 4's Today programme, Bernadette Garrihy, a member of the board of the College of Emergency Medicine, also said patients should only visit A&E this winter "as a last resort."